Provider Demographics
NPI:1013215755
Name:SOLID FOUNDATION FACILITIES INC
Entity Type:Organization
Organization Name:SOLID FOUNDATION FACILITIES INC
Other - Org Name:CHOANOKE VALLEY ADVP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:QP
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:RODGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-794-2385
Mailing Address - Street 1:224 WARD RD
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:NC
Mailing Address - Zip Code:27983-9074
Mailing Address - Country:US
Mailing Address - Phone:252-794-2385
Mailing Address - Fax:252-794-1923
Practice Address - Street 1:1321 1ST ST W
Practice Address - Street 2:
Practice Address - City:AHOSKIE
Practice Address - State:NC
Practice Address - Zip Code:27910-8842
Practice Address - Country:US
Practice Address - Phone:252-332-5709
Practice Address - Fax:252-862-4285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-04
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health